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Adrenal Insufficiency and Addison Disease

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Treatment for adrenal insufficiency involves hormone replacement or substitution. The specific replacement depends on whether cortisol or aldosterone are both deficient. If the condition is due to an adrenal infection, the affected person may regain some adrenal function when the infection resolves. Even when people have extensive and permanent damage to their adrenal cortex, they should be able to live healthy, relatively normal lives by replacing the missing hormones and observing a few precautions.

Damage to the hypothalamus or pituitary causing secondary adrenal insufficiency rarely resolves. Its treatment is the same as primary adrenal insufficiency, namely cortisol and aldosterone replacement. For other causes of secondary adrenal insufficiency, such as corticosteroid therapy, a period of monitoring medication is usually recommended. Cortisol production may eventually resume in these cases.

The major, and mostly avoidable, illness from adrenal insufficiency results from adrenal crisis. An adrenal crisis can be life-threatening and is treated with intravenous (IV) injections of glucocorticoids and large volumes of intravenous saline solution with the sugar dextrose. This treatment usually brings rapid improvement. Initiation of treatment as early as possible improves outcomes.

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